THE FIRST TWO THOUSAND DAYS FOR MOM AND BABY VI

November 5, 2018

Movement, Sleep and Pregnancy

Stress is a major problem with pregnancy outcomes as discussed in earlier chapters of the book. In this section we are going to look at two very important stress reducing lifestyle choices, physical activity and sleep stress. Physical activity while pregnant can come in the form of leisure time activity or during active work. In part two, we will look at sleep which is an aspect of daily life that is critical to maternal memory formation, growth and repair of cells throughout the body including her baby.

Physical activity in all humans is known to improve mental health, glucose metabolism, muscle growth, control weight, improve bowel function and much more. Before discussing the pregnancy data, let us look at some recent data.

In a Time Magazine from 2016, Mandy Oaklander explored the effects of exercise on human disease. She discussed the profound mammalian research of Dr. Mark Tarnopolsky. His lab published a 2011 study in PNAS that outlined the effects of exercise on a group of mice that are genetically set up to age rapidly, akin to Progeria in humans. (Oaklander M. 2016)(Tarnopolsky et. al. 2011)

In his 2011 research, we learn that these aging mice halt this decline when they undergo endurance exercise for 5 months versus a control sedentary group. In mice speak, these animals exercised on a wheel going 15 meters/minute for 45 minutes 3 times a week. This time frame mirrors human recommendations for exercise.

At the core science level, his group showed that the endurance exercise increased the production, capacity and overall function of the bodies cellular energy powerhouse known as the mitochondria. When mitochondria fail to perform, we suffer fatigue of all cells including those in our muscles, brain and skin. He hypothesized that the exercise caused a selective increase of the healthy mitochondria and repair of weakened cells while targeting unhealthy ones for programmed cell death.

They further go on to state that, "our data clearly support endurance exercise as a medicine and a lifestyle approach to improving systemic mitochondrial function, which is critical for reducing morbidity and mortality across the lifespan." (Tarnopolsky et. al. 2011)

Back to Mandy Oaklander's article where she interviewed Dr. Tarnopolsky about his new research, his recent comments were startling. When his group performed autopsies on the mice after being blinded to the exercise versus sedentary nature of the animals, they found that they could predict the movement pattern based on the animals fat content and tumor incidence.

""As for the mice who hit the wheel every day? "We haven't found a single tumor," he says. " I think if people saw, they'd be pretty motivated to exercise."" (Oaklander M. 2016)

There are thousands of articles related to the benefits of exercise on human health. It is long since settled that physical activity is a necessary part of a healthy life.

What do we know about physical activity during pregnancy?

In a few studies, we see that moderate to high level leisure exercise has significant benefits in pregnancy. There are decreased risks of gestational diabetes, excessive neonatal and maternal weight gain and preterm births. (Catov et. al. 2018)(Da Silva et. al. 2017)(Sanabria-Martinez et. al. 2015)

The reduction of gestational diabetes may be in part due to the up-regulated glucose transporter in the muscle as well as insulin sensitivity overall that occurs during muscle exercise. (Holten et. al. 2004)

These movement benefits during pregnancy also have significant long term health effects for the newborn with decreased low blood sugar levels at birth and decreased complications associated with early delivery that can be profound, especially if the preterm child is younger than 30 weeks gestation.

What does physical activity do for mood and stress? Moderate physical activity can reduce depression and mood disturbance during pregnancy which follows the general human data. (Hammer et. al. 2000)(Lewis et. al. 2011)(Reed et. al. 2009) Whether it is the runner's high or some other endorphin/hormonal pathway to happiness, we need to move to enhance our general wellness.

What are the current recommendations for maternal physical activity? From the American College of Obstetrics and Gynecology there is this consensus statement: Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. (Committee Opinion #650)